Definition

Alternative Names

Causes

Type 1 diabetes can occur at any age. It is most often diagnosed in children, adolescents, or young adults.

Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. There, it is stored and later used for energy. In type 1 diabetes, beta cells produce little or no insulin.

Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabetes.

The exact cause of type 1 diabetes is unknown. Most likely it is an autoimmune disorder. This is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. With type 1 diabetes, an infection or another trigger causes the body to mistakenly attack the cells in the pancreas that make insulin. Type 1 diabetes can be passed down through families.

Symptoms

High Blood Sugar

These symptoms may be the first signs of type 1 diabetes, or they may occur when blood sugar is high:

Being very thirsty

Feeling hungry

Feeling tired all the time

Having blurry eyesight

Feeling numbness or feeling tingling in your feet

Losing weight without trying

Urinating more often

For other people, these serious warning symptoms may be the first signs of type 1 diabetes, or they may happen when blood sugar is very high (diabetic ketoacidosis):

Exams and Tests

Random (nonfasting) blood glucose level -- you may have diabetes if it is higher than 200 mg/dL, and you have symptoms such as increased thirst, urination, and fatigue (this must be confirmed with a fasting test)

Oral glucose tolerance test -- diabetes is diagnosed if the glucose level is higher than 200 mg/dL 2 hours after drinking a special sugar drink

Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease.

See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.

Treatment

Because type 1 diabetes can start quickly and the symptoms can be severe, people who have just been diagnosed may need to stay in the hospital.

If you have just been diagnosed with type 1 diabetes, you may need to have a checkup each week until you have good control over your blood sugar. Your health care provider will review the results of your home blood sugar monitoring and urine testing. Your provider will also look at your diary of meals, snacks, and insulin injections. It may take a few weeks to match the insulin doses to your meal and activity schedule.

As the disease gets more stable, you will have fewer follow-up visits. Visiting your health care provider is very important so you can monitor any long-term problems from diabetes.

You are the most important person in managing your diabetes. You should know the basic steps to diabetes management:

Insulin lowers blood sugar by allowing it to leave the bloodstream and enter cells. Everyone with type 1 diabetes must take insulin every day.

Insulin must be injected under the skin using a syringe, insulin pen or pump. It cannot be taken by mouth because the acid in the stomach destroys insulin.

Insulin types differ in how fast they start to work and how long they last. The health care provider will choose the best type of insulin for you and will tell you at what time of day to use it. Some types of insulin may be mixed together in an injection to get the best blood glucose control. Other types of insulin should never be mixed. You may need insulin shots from one to four times a day.

Your health care provider or diabetes nurse educator will teach you how to give insulin injections. At first, a child's injections may be given by a parent or other adult. By age 14, most children can give their own injections.

People with diabetes need to know how to adjust the amount of insulin they are taking:

When they exercise

When they are sick

When they will be eating more or less food and calories

When they are traveling

DIET AND EXERCISE

By testing their blood sugar level, people with type 1 diabetes learn which foods and activities raise or lower their sugar level most. This helps them adjust their insulin doses to specific meals or activities to prevent blood sugar from becoming too high or low.

The American Diabetes Association and the American Dietetic Association have information for planning healthy, balanced meals. It can help to talk with a registered dietitian or nutrition counselor.

Regular exercise helps control the amount of sugar in the blood. It also helps burn extra calories and fat to reach a healthy weight.

Talk to your health care provider before starting any exercise program. People with type 1 diabetes must take special steps before, during, and after physical activity or exercise.

Checking your blood sugar level yourself and writing down the results tells you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check.

To check your blood sugar level, you use a device called a glucose meter. Usually, you prick your finger with a small needle called a lancet to get a tiny drop of blood. You place the blood on a test strip and put the strip into the meter. The meter gives you a reading that tells you the level of your blood sugar.

Keep a record of your blood sugar for yourself and your doctor or nurse. The numbers will help if you have problems managing your diabetes. You and your doctor should set a target goal for your blood sugar level at different times during the day. You should also plan what to do when your blood sugar is too low or high.

People with diabetes are more likely than those without diabetes to have foot problems. Diabetes damages the nerves. This can make you less able to feel pressure on the foot. You may not notice a foot injury until you get a severe infection.

Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected.

Get a foot exam by your health care provider at least twice a year and learn whether you have nerve damage.

Check and care for your feet every day. This is very important when you already have nerve or blood vessel damage or foot problems.

Make sure you wear the right kind of shoes. Ask your health care provider what is right for you.

PREVENTING COMPLICATIONS

Your doctor may prescribe medicines or other treatments to reduce your chance of developing eye disease, kidney disease, and other conditions that are common in people with diabetes. These conditions are called complications of diabetes.

Support Groups

There are many diabetes resources that can help you understand more about type 1 diabetes. You can also learn ways to manage your condition so that you can live well with diabetes.

Outlook (Prognosis)

Diabetes is a lifelong disease and there is no cure.

Tight control of blood glucose can prevent or delay diabetes complications. But these problems can occur, even in people with good diabetes control.

Possible Complications

After many years, diabetes can lead to other serious problems:

You could have eye problems, including trouble seeing (especially at night) and sensitivity to light. You could become blind.

Your feet and skin could develop sores and infections. If you have these sores for too long, your foot or leg may need to be amputated. Infection can also cause pain and itching.

Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to heart attack, stroke, and other problems. It can become harder for blood to flow to the legs and feet.

Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can also make it harder for men to have an erection.

Symptoms that your blood sugar is too high (being very thirsty, having blurry vision, having dry skin, feeling weak or tired, needing to urinate a lot)

You are having blood sugar readings below 70 mg/dL

You can treat early signs of hypoglycemia at home by eating sugar or candy, or by taking glucose tablets. If signs of hypoglycemia continue or your blood glucose level stays below 60 mg/dL, go to the hospital emergency room.

Prevention

Type 1 diabetes cannot be prevented. There is no screening test for type 1 diabetes in people who have no symptoms.

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